Natural childbirth advocates and lactivists like to claim that I hate vaginal births and breastfeeding. Never mind that I had four vaginal births and breastfed all four of my children. It seems beyond their powers of reasoning to imagine that someone could choose something for herself without insisting that everyone else ought to choose it too. They cannot fathom that a choice could be “best for me,” but that doesn’t make it “best.”

The claims made about natural childbirth and breastfeeding are not supported by the scientific evidence; benefits are exaggerated by professionals who earn their living from promoting them; and they are fundamentally misogynistic, inevitably requiring as they do re-immuring women into the home. So why has it become conventional wisdom that natural childbirth and breastfeeding are best? Because they denote privilege.

The ugly truth is that breastfeeding has become “best” because only the “best” people can afford to do it.

Privilege is a sine qua non of natural mothering and not merely the economic privilege that allows natural mothers to purchase expensive specialty products. One must have access to a highly technological lifestyle in order to give meaning to rejecting it.

…[T]hey reveal their class position through cultural signifiers that convey their acquisition of knowledge and value system—dinner party conversation around opinion pieces, bumper stickers that express political views and support for Greenpeace, and showing up at farmer’s markets. These behaviors and signifiers imply aspirational class values and also suggest the knowledge acquired to form them.

Thus:

Social norms and goods of the aspirational class reflect an implicit knowledge and procurement of knowledge that informs their consumption practices. Aspirational class leisure, whether reading the Economist, listening to NPR, or taking a yoga class, is imbued with knowledge and productivity in the same spirit as work.

And motherhood is a particular focus of the aspirational class, specifically because of the conspicuous leisure required to “perform” it. That’s why breastfeeding, for example, is so closely associated with maternal education and socio-economic class.

Mothering, writ large, has become a new channel for engaging in what Veblen termed conspicuous leisure. Breast-feeding and birthing practices are the most obvious examples of this, as playing sports or studying Greek were in Veblen’s time. Unlike a Louis Vuitton bag or a luxury car, these signifiers are not explicitly expensive but they do require significant investments of time, an even more precious commodity in modern society…

Wait! Aren’t these practices free for everyone?

While many aspects of motherhood seem costless — birthing choices, co-sleeping, carrying your baby, breastfeeding — women can only engage in these activities if they have the luxury of time and leisure and membership into cultural and social groups that encourage this form of motherhood. Certain maternal choices demonstrate the possession of both time and cultural capital that is truly impossible for many women to attain.

The author references French scholar Roland Barthes and his book Mythologies:

…Through the dominant values upheld by society we create “myths” around particular practices and consumer goods, which become “signifiers” of particular messages or dominant belief systems.

In our society, we have created a myth around motherhood, the myth of “attachment” mothering, which has become a critical signifier of membership in the aspirational class. Breastfeeding — because it can be “performed” before others — has become perhaps the most important signifier of all.

It is mainly prevalent in particular cultural and class groups — women with higher education levels who learn about the benefits of breast-feeding and women of higher income groups who can afford the insurance to deliver in baby-friendly hospitals with round-the-clock nurses and lactation consultants providing breastfeeding classes, expensive and efficient breast pumps, and help throughout the mother’s entire stay. One of the other significant predictors of breast-feeding success is duration of maternity leave: … In the United States, good maternity leave is a rare thing for all women, but those who receive it are primarily women in high-level professional jobs. …

What about everyone else?

…[A]s the sociologist Cynthia Colen summed it up, “In the United States, where only 12 percent of female workers and 5 percent of female low-wage workers have access to paid leave, most women are required to forgo income in order to breast-feed. This may be a less-than-ideal situation for middle-class women but an impossible situation for poor women who already are having trouble making ends meet.

That’s yet another reason why aggressive efforts to promote breastfeeding are cruel in the extreme:

Given that breast-feeding requires a whole host of resources and time that poor mothers may not have, low-income mothers are limited in their ability to breast-feed, even if it is not physiologically based. Breast-feeding might be the ideal choice, but these women often do not have the chance to do so.

The ugly truth is that breastfeeding has become “best” because only the “best” people can afford to do it.

Breastfeeding is the designer handbag of mothering. No woman should feel guilty about not owning a designer handbag and no mother should feel guilty about not breastfeeding. Just as a regular handbag is an excellent way to carry your wallet and car keys, formula feeding is an excellent way to nourish an infant. Contrary to claims of the aspirational class, breastfeeding is merely a class signifier, NOT a sign of maternal devotion.

This only applies to America. In developing countries is the other way around. Formula is way too expensive. The mom stays at home not because she can afford it, but because the wage is lower than daycare. The mom can only work if there is free daycare (aka grandmas).

MainlyMom

This aspirational class is not very wealthy tho. Often they would like to be wealthy, but are barely hanging on to middle class status. I delivered at an uoper east side manhattan hospital (beyonce delivered there too), but most of their patients are just as rich. C-section rate was high, 95% epidurals, don’t know about breastfeeding. These women didn’t want our need childbirth to be an achievement. They were to busy running their industries.

Hannah

I’ve been thinking about this, too. By no means am I rich, neither poor but I am pretty successful in my academic career. My midwife had explained to me how empowered giving birth would make me feel but it didn’t. My body is not what defines me, much less my bodily functions. And I’ve done things that were scarier and more challenging than laying on a hospital bed and enduring labour pain (even though that was pretty horrible).

MainlyMom

Similar here. Certainly wasn’t Rich when i had my first at 26, But was doing quite well. Ended up with an emergency section and felt brought to my knees/humbled/like I’d seen the face of God and witnessed a miracle. It made me see the “empowering” narrative as shifting the focus to the woman and away from the miracle, which in my probably mean opinion, misses the best part.

MainlyMom

Kind of like climbing a mountain and celebrating how awesome you are at the top instead of turning around, looking at the view, and feeling awed by how tiny and insignificant you are.

rational thinker

I agree, I find most of the women who brag about giving birth vaginally often have low self esteem and have no other accomplishments in their lives to be proud of so they brag about bodily functions instead. I knew someone like this and she told me she envied me cause I have major “bragging rights” cause of my first childbirth and she didn’t understand why I did not feel this way also. I told her that I don’t consider vaginal birth an accomplishment and the only reason I even talk about my sons birth with anybody is to warn expectant moms about what a large post dates baby can do to your body permanently. (I was over a week overdue and he got bigger during that time. Labored for 22hrs then spent 2 hrs pushing and I got 4rth degree tears, it was like one big hole down there). Now I have to cross my legs if I have to sneeze and I hate having sex. I don’t find this something to brag about, but I do think it is important to tell my story as a warning about the dangers of a post dates vaginal delivery. So needless to say I am no longer friends with this person.

MainlyMom

I’m so sorry about what you went through. Are you still recovering, or are you thinking this is as good as it’s gonna get? Hugs!

rational thinker

Thanks. It was almost 17 years ago so its just something I am gonna be stuck with.

BeatriceC

You’re not stuck with it! I had surgery shortly after my son’s 19th birthday. It was life changing.

BeatriceC

Please go see a urogyn! I was blown off by doctors for nearly 19 years before a urogyn took my complaints seriously. She immediately offered surgery to fix the incontinence issues and it was the best thing I’ve ever done. I can sneeze without fear. Sex is far better than it’s been since I was 20. My quality of life is dramatically improved. I don’t know where you live, but if you’re in the San Diego area, I can recommend a great doctor.

rational thinker

I am in new jersey. Maybe it is something I should look into, I just thought damage was done and now I have to live with it. The doctors never told me it could be fixed they just suggested panty liners for the incontinence.

BeatriceC

I spent nearly 19 years being ignored and told the same thing. A year ago a doctor finally said “you don’t have to live like this. We can fix it.” And she did. It’s been life changing. You don’t have to live like this. (And she also said she really wanted all the names of all my previous doctors so she could yell at them, because she was furious that I’d had to live so long like that.)

Sarah

Couldn’t do any harm to investigate. If there’s nothing to be done then at least you’ll know.

Daleth

These women didn’t want [or] need childbirth to be an achievement.

This! I don’t even understand how it’s an achievement to do something that can also be done by a rabbit, a cow, or a brain-dead woman on life support.

It’s your body doing it, not your intelligence or your will power or your ability to love. And it’s not even something you can train your body for or get better at by sheer work and determination, unlike, say, running marathons or dancing ballet or figure skating. I don’t get it.

The Bofa on the Sofa

This! I don’t even understand how it’s an achievement to do something that can also be done by a rabbit, a cow, or a brain-dead woman on life support.

It’s the beautiful mystery of childbirth:
Women have done it for time-immortal, and it’s perfectly natural and we don’t need no stinking doctors.

And when you do it, it is a wonderful achievement that you need to be celebrated for.

See also: Breastfeeding

WM__Caticorn

What if you are on medications and cannot breastfeed because of that?

Oh wait, it’s better if I am psychotic and depressed but can (in theory) breastfeed my baby because a sick mother is better then a well mother who formula feeds and is actually able to take care of the baby (I wonder if you believe someone who is psychotic because they are off their meds would actually breastfeed their kid if they are out of touch with reality lol)!

How about we don’t shame anyone, okay!

(If you were being sarcastic disregard this…)

Ayr

This aspirational class is not very wealthy tho. Often they would like to be wealthy, but are barely hanging on to middle class status.

I have noticed that too among many overly educated middle class women, who think they know everything about the human body because they used Google and WebMD. They want to show the world the achievement that all women were made for. As if they are the only ones who can do it. Frankly, I don’t care, and I don’t like being preached at by these so called birthing warriors. The worst ones are the ones who have water births at home and then post copious amounts of photos about it. (No offense intended to anyone who has done that, just the ones who think they need to brag.) Talking about how they had no drugs that could cause harm to the baby, and how beautiful it was, and how painless. As they sit in an inflatable pool, filled with flowers and essential oils (as if those are good for the baby) looking disheveled and tired like every other woman who gives birth. Sorry, but considering all the other stuff that comes out during birth, I’m not too keen on sitting a pool of water with it.

Georgie

I’m expecting my 2nd later this year and will (unfortunately) be giving birth in a BFHI hospital. I had very insufficient breastmilk with my first and spent the first 5 months intensely trying to increase my tiny supply (I made less than 2 oz in a day). My interactions with LCs were dehumanizing and distressing and their advice to triple-feed 8+ times/day triggered my obsessive tendencies in a bad way. I’m afraid I will be pressured to breastfeed exclusively again. The hospital is plastered in breastfeeding promotion and the nurses who cared for me last time were constantly asking about how the breastfeeding was going. How will I be able to speak up for myself next time around? I don’t think I’ll be able to cope with this again.

rational thinker

You can try telling them you are only formula feeding that way they may not send an LC to your room.

*Get a medical team together in advance to write in your chart that you are formula-feeding (or combo-feeding) under medical advice. I’m sure my OB/GYN and my son’s pediatrician would add that to my chart if I asked and I suspect yours would too especially if you spell out how miserable your postpartum period was while triple-feeding was.

*Bring your own formula. They sell cute little 2oz pre-mixed bottles. When anyone asks how breastfeeding is going, hold up a bottle of formula and say “Great!”

*Have a support person who can make it very, very clear to your bedside nurse in the postpartum unit – and the charge nurse ect if necessary that you are not interested in visits from LCs unless you request the visit in advance. Practice the phrase – “I’m doing great and I don’t want a visit now. Goodbye” in case an LC does show up. After you have said that once, ignore them. No eye-contact; no words. If an LC refuses to leave, pitch a fit. Call your nurse. Ask them to call security. Raise your voice.

Georgie

Thank you. This is good advice. If the same hospital LCs come this time I will have some choice words for them. I was too mentally exhausted the first time to question their advice but this time I won’t listen to them at all. It’s just such a shame that I have to worry about protecting myself when I go to give birth.

Poster Girl

This is all great advice. I’d also add that in general you can adopt the attitude that a lot of the militant crunchy mommies take when they head to the hospital– have a birth/postpartum plan, be a little bitchy if you need to, that kind of thing. All the stuff they tell breastfeeding mothers to do when anyone DARES mention a….*gasp*…..BOTTLE.

Bring formula with you and tell them to go to hell. Or try to organize home help [a cleaner, someone to help with child #1, so you can rest/care for the new baby] and sign yourself out of the hospital as soon as is feasible and recuperate at home.

Daleth

How will I be able to speak up for myself next time around?

Do you have a partner, friend or relative who can advocate for you? Or for that matter, a sympathetic doula?

Definitely bring some ready-to-drink formula with you. And you might want to come up with a script and just stick to it. “I’ve chosen to combo feed [or formula feed, whatever you choose]. Please respect that choice.” Repeat repeat repeat.

StephanieJR

The evil behind it all: bloody hipsters.

BeatriceC

I’m not sure I like the handbag analogy. There is a difference in quality between designer and Walmart brand bags. The analogy implies that formula is of lesser quality than formula, so I’m brisling at it. I carried a Coach bag every day for 16 years before it fell apart. My friends who’ve carried Walmart brand bags replace them a couple times a year because they fall apart. Perhaps the analogy would work better between high end designers and every day designers, but that seems a bit exclusionary, since people who struggle financially can’t afford even every day designers. I’m trying to think of a better analogy and coming up empty. This is a tough one.

demodocus

How about sheep’s wool? The cheap stuff you can get from Joann’s is just as effective as the one from the indie dyer who knows the actual names of the sheep who provided the fleece. Sure, there’s differences that you could do, like merino or blue-faced leicester, but it’s a mark of privilege just to know those breeds exist, and anyway, my sweater is just as warm.

MainlyMom

IME luxury brand products don’t last longer any more. Maybe 20 years ago they did, but so did everthing. Get a new coach bag now abd you’re lucky to get 2 years out of it. And probably only because you treat it more gently because it’s pricey.

Amy Tuteur, MD

Dr. Amy Tuteur is an obstetrician gynecologist. She received her undergraduate degree from Harvard College in 1979 and her medical degree from Boston University School of Medicine in 1984. Dr. Tuteur is a former clinical instructor at Harvard Medical School. She left the practice of medicine to raise her four children. Her book, Push Back: Guilt in the Age of Natural Parenting (HarperCollins) was published in 2016. She can be reached at DrAmy5 at aol dot com...
More